An unforeseen accident or disaster that causes damages and losses is an overwhelming and stressful time for everyone. When an insurance agency denies your claim for the policy you purchased to protect yourself, it significantly increases your anxiety.
Consumers purchase insurance policies to protect themselves and cover losses when necessary. Unfortunately, providers commonly search for ways to minimize the payout or outright deny the claim. Speak with one of our knowledgeable insurance claims lawyers for more information.
Reasons Insurance Adjusters Deny Claims
One common reason adjusters deny claims is that the damage is not covered under the policy or the policyholder has reached their coverage limit. Reading the entire policy, including the fine print, is essential to understand its limits and ensure the company is not excluding specific coverage needed, even if the consumer mentions needing the coverage at the time of purchase. Other typical reasons for denials include:
- Policy exclusions
- Damages occurred outside the policy period
- False or misleading statements
- Insufficient preventative measures
- Policyholder shares some fault for the damages
- Insufficient documentation was provided with the request for payment under the policy
Insurance companies must ensure they comply with state laws, and they have a legal obligation to provide notification of denials with detailed reasons for the decisions.
Denial of Valid Claims
Unfortunately, valid claims are commonly denied, which breaches the contract agreement. Our insurance claims attorney can determine if the company violated state insurance laws and help determine the most effective way to collect a settlement under the policy. They could handle the communication and fight for the maximum payout to cover the policyholder’s losses.
According to the regulations under the Texas Insurance Code § 541.060, it is unlawful for insurance providers to engage in unfair and deceitful practices. That includes purposely misrepresenting the facts or the limits of coverage and failing to provide policyholders with a prompt and detailed reason for denial.
The legislation further prohibits them from refusing to pay a claim without a reasonable investigation and review of the facts. Regardless of the reason insurers deny claims under policies, taking quick action to resolve the problem is crucial to protecting your rights under the statutes.
Call a Qualified Insurance Claims Attorney When Your Claim Is Denied
While everyone purchases insurance policies to protect themselves and provide peace of mind, insurance agencies deny billions of dollars in claims yearly. These businesses prioritize profit and seek ways to minimize losses through denials.
While the process requires time and additional work, you have the right to contest denials or underpayments when you disagree with the insurer’s decision. Schedule a free consultation with our insurance claims denial lawyer when you need help collecting a settlement under your policy.
